Primary Prevention of Cervical Cancer
Oncogenic human papillomavirus (HPV) types (mainly types 16 and 18) cause almost all cervical cancers.10 An HPV infection is commonly transmitted sexually.11 About 43% of US females ages 14-59 years have a current genital HPV infection.12 Most infections will clear within 1 year without intervention13-16 but females with persistent infections can develop serious disease if left untreated. The HPV vaccines available in the United States include a bivalent vaccine that prevents infection with HPV types 16 and 18; a quadrivalent vaccine that prevents infection with HPV types 6, 11, 16, and 18; and a 9-valent vaccine that prevents infection with HPV types 6, 11, 16, 18, 31, 33, 45, 52, and 58. Both the bivalent and quadrivalent vaccines offer protection against HPV types 16 and 18, which account for 66% of all cervical cancers, and the 9-valent vaccine protects against five additional types accounting for an additional 15% of cervical cancers. Both the quadrivalent and 9-valent vaccines protect against HPV types causing 90% of genital warts.16 Guidelines currently recommend that all 11- to 12-year- old females receive two doses of either HPV vaccine, with catch-up vaccination for 13- to 26-year-old females.16 In addition to HPV infection, factors that increase a woman’s risk of cervical cancer include human immunodeficiency virus (HIV) infection, a compromised immune system, and cigarette smoking.